It was an average morning in a GP practice. It could have been an average afternoon. But it definitely wasn’t the evening or nightshift. Or weekend. Why? This is ‘GP Land’ – a magical place for those who have just come from the ‘Hospital World’. Nice, isn’t it. Well, on an average generic hour, between Monday to Friday – but not at midday (that’s when the drug reps come and feed you) – a pleasant mother walked in with her young child:
“Doctor, I’m VERY concerned about my son.”
What is it?
VERY concerned? Am I prepared to deal with this?
I’m not very good with kids. Lets just put that out there. Of course I didn’t tell this to mom – I kept a very professional ‘Doctor’ face on, showing a degree of concern, and replied, in an entirely genuine sympathetic tone, with something along the lines of:
“Oh dear…. and what are you concerned about?”
The boy looked very well I must say, so I was comfortable enough he wasn’t acutely unwell.
Huh? Wasn’t expecting to hear that…
“Sorry, what was that?”
“He’s … short?” I replied.
Yup, definitely wasn’t expecting “short”, but rather something like chronic abdominal pain, weight loss, difficulty breathing at night…stuff like that. I looked over the young boy, reviewing him, as he stood beside his mother, propped against her like a fallen tree. He wasn’t skinny, wasn’t overweight. Looked about right. So malnutrition probably isn’t the case.
Looking at the mother – I could tell she was short as well – perched on the chair, her ankles were extended so that her toes just touched the ground, barely preventing pendulum like legs.
“Yes. He’s short Doctor. All the other boys at school are taller than he is!”
Ahhh…I see. The good old worried mom thing. I mean this mom wasn’t old, its just an age old thing for moms to be worried about their children. The whole ‘My child isn’t as good as the other children – can you fix him doctor?!’ Because doctors can fix everything, right? In most cases, there isn’t anything to fix.
“Oh…I see” I replied. “He doesn’t…look…that short…how old is he again?”
“Right, come over here young man.”
I brought the young boy over to the wall, and very precisely measured his height with a dodgy piece of wood, which was hanging onto the wall with its dear life. As a doctor you sometimes feel a certain je ne sais quoi. An instinct. An almost subconscious processing of body language and actions. Your brain instinctively collates information – the bright eyes, the smiles, the energetic movements, the appropriate amount of muscle and fat on the arms, legs and tummy. The little jump up against the wall where the measuring stick is, the inspection of the measuring stick like a little sparrow. Excitement, intrigue from the young boy – something you don’t see in ill children. All of these things, in a matter of seconds, maybe even milliseconds, leads you to this feeling – everything is OK.
After measuring the lively young boy, and quickly popping him on the scales afterwards, we returned to our seats, I in mine, mom in hers, boy perched on Mom’s thigh.
“Let me just look at this growth chart…”
This is the bit when you go through the routine of looking at the chart, knowing what you’re going to find – the boy is exactly where he should be on the growth chart.
“Well…just as I suspected…” I said.
“Oh! And what’s that?!” Mom worryingly replied. I don’t think she understood the tone in my voice. It was supposed to have a sarcastic undertone. She clearly missed it. The mother was foreign to this GP land – as was I – either way, the tone of my comment inadvertently prompted worry.
Note to self – if someone is not on the same comedic wavelength, don’t use sarcasm. It only worries or confuses patients. I needed to settle the worries, fast:
“He’s absolutely fine. Growing perfectly, decent height and weight.”
“Oh good! Good doctor!”
“How tall is your husband may I ask?”
“My husband? Oh about the same as me!”
Oh dear. The husband was the same size as the hobbit sized mother. The kid really DOESN’T have a chance. Definitely not going to be a basketball player….or any other sportsman….maybe a Jockey.
“Ohhh riiiigghhhht…..so he’s…short as well, is he?”
“Well…yes, he is, I guess you could call him short.”
You guess! A five foot man? There’s no guessing here. But I suppose to her – that’s average height, its relative.
“The only reason I ask, is because if you’re short, and your husband is short, well, there’s only a certain…. range of height your son will be…and the range isn’t… massive.”
“Ohhhh. I see”, Mom replied.
This comment seemed to come as a revelation to Mom. Either way, perhaps it’s a lesson learned for doctors – what may seem obvious for you, may not seem so obvious for the patient.
It mattered to mom, so it mattered to me.
Mom was pleased; she and the boy skipped out of the examination room and lived happily ever after.
I just made that last bit up…I don’t know what happened – never saw them again. In the doctor realm, this means that either 1) they were happy, or 2) they were not happy and didn’t want to come back to the practice. Oh well. I’ll be keeping my eye out on the horse races…might see that young boy all ‘grown’ up someday.